{extend name="index_layout"/}
{block name="main"}
<form class="layui-form" method="post">
    {:token()}
    <div class="layui-form-item">
        <label class="layui-form-label">退款账户名</label>
        <div class="layui-input-block">
            <input type="text" name="row[realname]" lay-verify="required" autocomplete="off" placeholder="请输入客户账户名" class="layui-input" value="">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">退款金额</label>
        <div class="layui-input-block">
            <input type="text" name="row[money]" lay-verify="required" autocomplete="off" placeholder="请输入客户退款金额" class="layui-input" value="">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">退款账号</label>
        <div class="layui-input-block">
            <input type="text" name="row[bank_card_number]" lay-verify="required" autocomplete="off" placeholder="请输入客户退款账号" class="layui-input" value="">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">审核情况</label>
        <div class="layui-input-block">
            <textarea name="row[status]" placeholder="请输入审核情况（选填）" class="layui-textarea"></textarea>
        </div>
    </div>
    <div class="layui-form-item layer-footer">
        <div class="layui-input-block">
            <button class="layui-btn" lay-submit>立即提交</button>
            <button type="reset" class="layui-btn layui-btn-primary">重置</button>
        </div>
    </div>
</form>
{/block}
{block name="script"}
<script type="text/javascript">
layui.use('yznForm', function() {
    var yznForm = layui.yznForm;
    yznForm.bindevent($("form.layui-form"));
});
</script>
{/block}
